TY - JOUR
T1 - Duration of the second stage of labor in multiparous women
T2 - maternal and neonatal outcomes
AU - Cheng, Yvonne W.
AU - Hopkins, Linda M.
AU - Laros, Russell K.
AU - Caughey, Aaron B.
N1 - Funding Information:
This study was supported in part by the National Institute of Child Health and Human Development, Grant HD01262, for a Women’s Reproductive Health Research Scholar (A.B.C.).
PY - 2007/6
Y1 - 2007/6
N2 - Objective: This study was undertaken to examine perinatal outcomes associated with the second stage of labor in multiparous women. Study Design: This is a retrospective cohort study of all term, cephalic, singleton births delivered by multiparous women between1991 and 2001. Duration of the second stage of labor was stratified into hourly intervals: 0-1 hour, 1-2 hours, 2-3 hours, and 3 hours or longer. Perinatal outcomes were analyzed by using χ2 test and multivariable logistic regression models, by using P<.05 and 95% CI to indicate statistical significance. Results: Compared with women who delivered between the 0- and 2- hour interval, women with a second stage more than 3 hours had higher risks of operative vaginal deliveries (odds ratio = 13.27; 95% CI [9.38-18.8]), cesarean deliveries (odds ratio = 6.00; [4.06-8.86]), and maternal morbidity including third- or fourth-degree perineal lacerations, postpartum hemorrhage, and chorioamnionitis. Their neonates had higher risks of 5-minute Apgar score less than 7 (odds ratio = 3.63; 95% CI[1.77-7.43]), meconium stained amniotic fluid (odds ratio = 1.44; 95% CI [1.07-1.94]), admission to intensive care nursery (odds ratio = 2.08; 95% CI [1.15-3.77]), composite neonatal morbidity (odds ratio = 1.85; 95% CI [1.23-2.77]), and longer neonatal stay in the hospital (odds ratio = 1.67; 95% CI [1.11-2.51]). Conclusion: Multiparous women with a second stage of 3 hours or greater are at increased risks for operative deliveries, peripartum morbidity, and undesirable neonatal outcomes. These outcomes should be considered in the management of multiparous women with a second stage of labor beyond 3 hours.
AB - Objective: This study was undertaken to examine perinatal outcomes associated with the second stage of labor in multiparous women. Study Design: This is a retrospective cohort study of all term, cephalic, singleton births delivered by multiparous women between1991 and 2001. Duration of the second stage of labor was stratified into hourly intervals: 0-1 hour, 1-2 hours, 2-3 hours, and 3 hours or longer. Perinatal outcomes were analyzed by using χ2 test and multivariable logistic regression models, by using P<.05 and 95% CI to indicate statistical significance. Results: Compared with women who delivered between the 0- and 2- hour interval, women with a second stage more than 3 hours had higher risks of operative vaginal deliveries (odds ratio = 13.27; 95% CI [9.38-18.8]), cesarean deliveries (odds ratio = 6.00; [4.06-8.86]), and maternal morbidity including third- or fourth-degree perineal lacerations, postpartum hemorrhage, and chorioamnionitis. Their neonates had higher risks of 5-minute Apgar score less than 7 (odds ratio = 3.63; 95% CI[1.77-7.43]), meconium stained amniotic fluid (odds ratio = 1.44; 95% CI [1.07-1.94]), admission to intensive care nursery (odds ratio = 2.08; 95% CI [1.15-3.77]), composite neonatal morbidity (odds ratio = 1.85; 95% CI [1.23-2.77]), and longer neonatal stay in the hospital (odds ratio = 1.67; 95% CI [1.11-2.51]). Conclusion: Multiparous women with a second stage of 3 hours or greater are at increased risks for operative deliveries, peripartum morbidity, and undesirable neonatal outcomes. These outcomes should be considered in the management of multiparous women with a second stage of labor beyond 3 hours.
KW - multiparous women
KW - perinatal complications
KW - prolonged
KW - second stage of labor
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U2 - 10.1016/j.ajog.2007.03.021
DO - 10.1016/j.ajog.2007.03.021
M3 - Article
C2 - 17547906
AN - SCOPUS:34249741006
SN - 0002-9378
VL - 196
SP - 585.e1-585.e6
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 6
ER -